La Salle University School of Nursing

1. La Salle UniversitySchool of Nursing Occupational & Safety Health Administration (OSHA) Orientation for Faculty

2. Welcome to La Salle! The following slide show focuses on the following objectives: • Discusses role of microorganisms and pathogens in chain of infection • Describes bloodborne, airborne, droplet, contact, vehicle and vector transmission of pathogens • Explains protective interventions for decreasing risk of infection

3. Please Note: Faculty • With proof of attendance at an OSHA orientation during this past year you do not need to review this presentation • Just take the post-test and submit it to the Dean’s secretary

4. Bloodborne Pathogens & Other Infectious Agents

5. Microorganisms are Everywhere • Most do not cause disease and are important for everyday life • Some cause infection and disease (Pathogens)

6. Who Can Get Infection? • Host = you, the patient, patient’s family, other healthcare workers, or visitors • Anyone can be at-risk for developing infection after exposure if the circumstances are night.

7. Microorganisms Are Spread in These Ways

8. Airborne Transmission • Person with infection coughs, sneezes organism into air • Organism remains suspended in air • Susceptible person breathes in organism and may become infected • Example: TB, Measles, chickenpox

9. Droplet Transmission • Droplets containing microorganisms contact mucous membranes of susceptible host • Example: Influenza, meningococcal meningitis, rubella, mumps

10. Contact Transmission • Transferring organisms to another person or surface • Touching surfaces that are contaminated with pathogens Example: Chickenpox, C. difficile diarrhea, lice, scabies, HIV, Hepatitis B, Hepatitis C

11. Vehicle Transmission • Organism passed on in food or water Example: Hepatitis A, Salmonella, Shigella, Giardia, E. coli 0127

12. Vector Transmission • Etiologic agent must pass through animal or insect • Example: Lyme disease, Rabies, West Nile Virus, Malaria

13. Stopping Infection Transmission • We can stop infection from spreading to others by interrupting the way the microorganisms get from place to place.

14. Things You Can Do Prevent the spread of infection by: • Washing your hands • Using Standard Precautions • Personal Protective Equipment • Safety devices • Safe work practices

15. Best Practice • “Handwashing is the single most effective method to prevent the spread of infection.” Centers for Disease Control & Prevention

16. Handwashing • Running water – comfortable temperature • Soap – friction to all surfaces for 15-20 seconds • Backs of hands, between fingers, under nails • Rinse well • Dry thoroughly • Use paper towel to turn off faucet (touching faucet recontaminates you)

17. Standard Precautions • Protect you from both known and unknown sources of infection • Should be used for everyone regardless of diagnosis or infectious state

18. Be Aware! • Germs may enter through cuts, punctures, broken skin, eyes-nose-throat and mucous membranes

19. Standard Precautions • WEAR GLOVES when touching blood, body fluids, excretions, broken (non-intact) skin, contaminated items • WASH HANDS before and after any patient contact, after gloves removed, before invasive or sterile procedures

20. Standard Precautions • Use personal protective equipment (PPE = gowns, masks, eyewear, gloves, etc.) to prevent exposure from splash of blood or body fluids to face or body

21. Infectious Waste • Use gloves to discard items soiled with blood or body fluids, IV tubing, urinary catheters & nasogastric tubes into the infectious waste containers • Wash hands after removing gloves

22. Prevent Sharps Injuries • Be careful with sharps • Activate safety mechanisms • Don’t recap needles • Get help with uncooperative patients • Dispose immediately after use into designated sharps container

23. How to Clean a Blood Spill • Put on gloves (if spill is large, wear gown) • Use paper towels to absorb the blood, discard into red bag • Clean area with soap & water • Disinfect area with product such as Hepacide • Discard all materials, including gloves into red bag • Wash hands • For larger spills, call Environmental Services

24. Soiled Linen • Handle all linen as though it has blood or body fluids on it • Place in linen bag • Wash hands after handling soiled linen

25. Isolation • Sometimes additional precautions are necessary for certain infections • Airborne infections such as TB, measles, or chickenpox need special air handling • Check your facility’s Infection Control Manual for specific infections that need extra precautions (isolation)

26. TB Skin Test - PPD • You should have a PPD every year to check for TB • A negative PPD usually means you are not infected with TB • A positive skin test for TB (PPD) means you may have been exposed to tuberculosis and should be evaluated for active TB

27. OSHA Bloodborne Pathogen Rule • Intent: To reduce or eliminate employee’s occupational exposure to bloodborne pathogens • Any healthcare facility should have: • Written exposure control plan • Engineering controls (e.g., sharps boxes, etc) • Safe work practices and safety devices • Hepatitis B vaccine available • Education and post-exposure follow-up

28. Occupational Exposure to Bloodborne Pathogens • Occupational Exposure can occur following contact with blood or body fluids in these ways: • Percutaneous – any new break in the skin caused by contaminated needle or other sharp object • Mucous membrane contact – any splash or splatter of blood and/or body fluids to the eys, ears, nose, mouth, etc. • Non-intact (broken) skin contact – any contact o blood and/or body fluid with an existing break in the skin

29. Bloodborne Pathogens • These pathogens are found in the blood and certain body fluids of people who have these infections • Hepatitis B • Hepatitis C • Hepatitis D • Human Immunodeficiency Virus (HIV)

30. Transmission of Hepatitis • Hepatitis B, C, and D are spread by contact with blood or body fluids containing Hepatitis B virus, or Hepatitis C virus, or Hepatitis D virus • Prevention includes • Always using Standard Precautions • Getting your hepatitis B vaccine to prevent hepatitis B

31. Hepatitis B Vaccine • Hepatitis B Vaccine protects you from getting Hepatitis B • Hepatitis B vaccine is available from primary care providers • Most health care facilities provide it for full-time employees

32. How is HIV Transmitted? • Occupational exposure – blood or mucous membrane contact with infected blood or body fluids • Sexual contact with HIV-infected person: anal, genital, oral, and other • Blood to blood: injecting drug use, transfusion of blood or blood products • Perinatally from HIV-infected mother to infant before, during or after birth

33. Infection Control for Home & Work • Wash hands • Before and after contact with patients and/or equipment • After contamination and toileting before eating and touching face • After removing gloves • Between “dirty” and “clean” procedures

34. Infection Control for the Healthcare Worker • Always practice safety • Use Standard Precautions routinely • Consider all patients potentially infected • Add other isolation precautions as needed • Plan ahead, anticipate potential problems, get help • Follow procedures, don’t short-cut • Use safety devices that are available

35. Infection Control for the Healthcare Worker • Safe practices • Practice sharps safety: don’t recap; activate safety devices and dispose of sharp items immediately after use into designated container • Use engineering controls • Wear personal protective equipment (gloves, gowns, goggles, or masks) to protect against splash of blood or body fluids to face or clothing

36. Infection Control for Everyone • Be kind to your immune system • Get enough rest • Eat balanced diet • Reduce or manage stress in your life • Keep immunizations up-to-date, including getting Hepatitis B vaccine and annual influenza vaccine

37. Post-Exposure Follow-up • If you have a blood or body fluid exposure: • Wash/flush with water or saline • Report the exposure immediately to your supervisor; complete an incident report • Go for immediate medical evaluation and follow-up via Occupational Health (go to Emergency Department if exposure occurs off-shift); Faculty on affiliation may be expected to follow up with their own primary care provider

38. Post-Exposure Follow-up • If you are exposed to a communicable disease, such as chickenpox, TB, or measles: • Report the exposure to your supervisor and complete an incident report • Review your immune status (have you had this infection or been immunized for it?) • Go for medical evaluation

39. Do Not Come to the Facility • If you have a fever • If you are getting sick with a cold, influenza, or other communicable disease (example, measles, chickenpox) • If you have Conjunctivitis (until on antibiotics and eye drainage stops) • If you have Diarrhea and fever (until diarrhea stops) • If you aren’t sure whether you should work, talk with your supervisor or director

40. Summary • You are in control of your own protection • Use hand washing consistently • Use personal protective equipment • Think!!